| NPI | 1588099220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANDRE COX Program Director 601-880-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 1348) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2013-09-12 |